Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Which social determinant(s) most affects this health issue? Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
National Healthcare Issue: Nursing Shortage and Burnout
One of the most pressing national healthcare issues affecting the U.S. today is the persistent nursing shortage, which has been exacerbated by the COVID-19 pandemic and continues to place immense strain on healthcare systems. The nursing shortage has evolved into a multifaceted crisis involving workforce attrition, burnout, staffing gaps, and increasing patient acuity levels. This issue is not only affecting patient outcomes but also increasing the burden on existing healthcare staff, resulting in decreased morale, increased turnover rates, and reduced quality of care.
Impact on My Work Setting
As a psychiatric mental health nurse practitioner (PMHNP) in a clinical setting, the nursing shortage has had a significant impact. With fewer registered nurses (RNs) and support staff available, psychiatric services are often delayed or inadequately staffed. This leads to longer wait times for patients experiencing mental health crises, increased reliance on emergency departments, and difficulty in maintaining continuity of care. The existing staff is often required to take on expanded roles and extended hours, contributing to heightened stress, emotional exhaustion, and potential for error in mental health assessments and medication administration. The therapeutic alliance—critical in mental health care—is often compromised due to time constraints and staff turnover, affecting patient engagement and outcomes.
Social Determinants of Health Affecting the Issue
Several social determinants of health (SDOH) exacerbate the nursing shortage and its impact. The most significant among these include:
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Economic Stability: Many healthcare workers face wage stagnation or insufficient compensation compared to the demands of the job. This economic pressure leads to high attrition rates, particularly in high-stress specialties like psychiatry.
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Education Access and Quality: There are limited slots in nursing programs and a lack of faculty to train new nurses, which slows the pipeline of new professionals entering the field.
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Healthcare Access and Quality: Communities with inadequate mental health infrastructure place additional strain on limited psychiatric nursing resources, especially in rural and underserved areas.
Organizational Response and Implemented Changes
In response to the ongoing nursing shortage and its effects on mental health services, my healthcare organization has implemented several strategies:
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Flexible Staffing Models: The organization has adopted flexible shift scheduling and hybrid telehealth options for PMHNPs to provide consultations remotely, reducing physical burden and expanding access to patients in rural areas.
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Retention Initiatives: To improve nurse retention, wellness programs have been introduced, including regular debriefing sessions, mental health days, and access to in-house counseling services. Bonuses and tuition reimbursement programs have also been offered to encourage continued employment and advanced training.
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Task-Shifting and Interdisciplinary Collaboration: The workload is being redistributed among interdisciplinary team members, such as social workers and psychiatric technicians, to free up PMHNPs for more complex clinical tasks. This collaborative care model has improved workflow efficiency and patient outcomes.
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Educational Partnerships: The facility has partnered with local universities to serve as a clinical rotation site for psychiatric nursing students, creating a pipeline for future employment and exposure to the demands of mental health practice.
For example, since implementing telepsychiatry services, we have reduced patient appointment wait times by 40% and decreased the rate of no-shows due to travel or mobility issues. This has not only improved care access but also relieved some workload pressures on in-person staff.
Conclusion
The nursing shortage remains a critical national healthcare issue that deeply affects psychiatric care delivery. Rooted in economic, educational, and access-related social determinants, this stressor demands coordinated responses at both the national and organizational levels. My work setting has responded through innovation in staffing, mental health support for staff, and community partnerships. However, long-term solutions must include policy reform, expanded educational funding, and sustained support for mental health professionals to ensure the quality and continuity of care.
References:
American Association of Colleges of Nursing. (2022). Nursing shortage fact sheet. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage
National Academy of Medicine. (2021). Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.
World Health Organization. (2021). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health